The evolving management of endocrine disorders induced by checkpoint inhibitors: insights from the CIITED group

Immune checkpoint inhibitor (ICI) induced endocrinopathies are a commonly encountered immune-related adverse event during cancer treatment. Several oncology and endocrinology groups have put together guidelines on the management of these adverse events. However, the management is evolving as we learn more about the natural history of these entities.

A thorough literature search for articles pertaining to ICIs and endocrinopathies was performed and supplemented by expert opinions of the authors. Additionally, we present unanswered questions that need further research including ICI-mediated effects on diabetes and bone health.

While there is a consensus on the management of endocrinopathies caused by ICI, there is a lot unknown. While ICI can be safely continued, conditions like adrenal insufficiency, primary hypothyroidism, and diabetes resulting from ICI require lifelong hormone replacement. However, there are several questions unanswered. Hence, the endocrinologists at our cancer center have come together as a working group to explore 'checkpoint inhibitor induced toxic endocrinopathies and diabetes' (CIITED). Future directions intended to explore are the long-term sequelae of ICI endocrinopathies as well as possible role for immune modulating therapies in their management.